Bai Lin, Wushouer Haishaerjiang, Huang Cong, Luo Zhenhuan, Guan Xiaodong, Shi Luwen
Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, China.
Center for Strategic Studies, Chinese Academy of Engineering, Beijing, China.
Front Pharmacol. 2020 Jun 10;11:719. doi: 10.3389/fphar.2020.00719. eCollection 2020.
In terms of medical costs, prostate cancer is on the increase as one of the most costly cancers, posing a tremendous economic burden, but evidence on the health care utilization and medical expenditure of prostate cancer has been absent in China.
This study aimed to analyze health care utilization and direct medical costs of patients with prostate cancer in China.
Health care service data with a national representative sample of basic medical insurance beneficiaries between 2015 and 2017 were obtained from the China Health Insurance Association database. We conducted descriptive and statistical analyses of health care utilization, annual direct medical costs, and composition based on cancer-related medical records. Health care utilization was measured by the number of hospital visits and the length of stay.
A total of 3,936 patients with prostate cancer and 24,686 cancer-related visits between 2015 and 2017 were identified in the database. The number of annual outpatient and inpatient visits per patient differed significantly from 2015 to 2017. There was no obvious change in length of stay and annual direct medical costs from 2015 to 2017. The number of annual visits per patient (outpatient: 3.0 vs. 4.0, P < 0.01; inpatient: 1.5 vs. 2.0, P < 0.001) and the annual medical direct costs per patient (US$2,300.1 vs. US$3,543.3, P < 0.001) of patients covered by the Urban Rural Resident Basic Medical Insurance (URRBMI) were both lower than those of patients covered by the Urban Employee Basic Medical Insurance (UEBMI), and the median out-of-pocket expense of URRBMI was higher than that of UEBMI (US$926.6 vs. US$594.0, P < 0.001). The annual direct medical costs of patients with prostate cancer in Western regions were significantly lower than those of patients in Eastern and Central regions (East: US$4011.9; Central: US$3458.6; West: US$2115.5) (P < 0.001).
There was an imbalanced distribution of health care utilization among regions in China. The direct medical costs of Chinese patients with prostate cancer remained stable, but the gap in health care utilization and medical costs between two different insurance schemes and among regions still needed to be further addressed.
在医疗费用方面，前列腺癌作为成本最高的癌症之一，其发病率正在上升，带来了巨大的经济负担，但中国缺乏关于前列腺癌患者医疗服务利用情况和医疗支出的证据。
本研究旨在分析中国前列腺癌患者的医疗服务利用情况和直接医疗费用。
从中国医疗保险协会数据库中获取了2015年至2017年具有全国代表性的基本医疗保险受益人的医疗服务数据。我们基于癌症相关医疗记录对医疗服务利用情况、年度直接医疗费用及其构成进行了描述性和统计分析。医疗服务利用情况通过就诊次数和住院天数来衡量。
数据库中识别出2015年至2017年共有3936例前列腺癌患者和24686次癌症相关就诊。2015年至2017年，每位患者的年度门诊和住院就诊次数存在显著差异。2015年至2017年，住院天数和年度直接医疗费用没有明显变化。城乡居民基本医疗保险（URRBMI）覆盖患者的每位患者年度就诊次数（门诊：3.0次对4.0次，P<0.01；住院：1.5次对2.0次，P<0.001）和每位患者年度医疗直接费用（2300.1美元对3543.3美元，P<0.001）均低于城镇职工基本医疗保险（UEBMI）覆盖患者，且URRBMI的自付费用中位数高于UEBMI（926.6美元对594.0美元，P<0.001）。西部地区前列腺癌患者的年度直接医疗费用显著低于东部和中部地区患者（东部：4011.9美元；中部：3458.6美元；西部：2115.5美元）（P<0.001）。
中国各地区医疗服务利用情况分布不均衡。中国前列腺癌患者的直接医疗费用保持稳定，但两种不同保险方案之间以及各地区之间在医疗服务利用和医疗费用方面的差距仍需进一步解决。
